Hepatic steatosis is a risk factor for hepatocellular carcinoma in patients with chronic hepatitis C virus infection

Abstract

BACKGROUNDHepatic steatosis is one of the histopathologic features of chronic hepatitis C. It was reported recently that the expression of hepatitis C virus (HCV) core protein in transgenic mice induced hepatocellular carcinoma (HCC) in association with steatosis. The objective of this study was to determine the relation between hepatic steatosis and hepatocarcinogenesis in patients with chronic HCV infection.METHODSThe authors studied 161 patients with chronic HCV infection who were diagnosed at Nagasaki University Hospital, Nagasaki, Japan, between January 1980 and December 1999. Age, gender, body mass index (BMI), habitual drinking, diabetes mellitus, serum alanine aminotransferase (ALT) level, HCV serotype, serum level of HCV core protein, interferon (IFN) treatment, hepatic fibrosis inflammation, and hepatic steatosis were studied with regard to their significance in the development of HCC using univariate and multivariate analyses.RESULTSThe cumulative incidence rates of HCC were 24%, 51%, and 63% at 5 years, 10 years, and 15 years, respectively. Multivariate analysis identified hepatic steatosis, together with aging, cirrhosis, and no IFN treatment, as independent and significant risk factors for HCC (P = 0.0135, P = 0.0390, P = 0.0068, and P = 0.0142, respectively). In addition, hepatic steatosis was correlated with BMI, serum ALT levels, and triglyceride levels.CONCLUSIONSThe findings of the current study indicate that hepatic steatosis is a risk factor for HCC in patients with chronic HCV infection. Patients with chronic HCV and hepatic steatosis should be monitored carefully for HCC. Cancer 2003;97:3036–43. © 2003 American Cancer Society.DOI 10.1002/cncr.11427

Steatosis: Co-factor in Other Liver Diseases *

“…Ohata et al 74 recently found that steatosis was independently associated with an increased risk of HCC in chronically infected patients, and some support for this clinical finding is found in animal studies. Transgenic mice expressing HCV viral proteins [75][76][77] have an increased risk of developing hepatocellular adenomas and carcinomas.…”

“…8 The development of cirrhosis in patients with HCV may be associated with regression of steatosis, 21 as has previously been documented in non-alcoholic steatohepatitis (NASH). 22,23 The mechanisms leading to a reduction in steatosis in the liver with cirrhosis remain Mihm et al 99 Yes Ratziu et al 18 Yes Fartoux et al 19 Yes Czaja et al 9 Yes Yes Yes Hourigan et al 10,11 Yes Yes Yes Adinolfi et al 12 Yes Yes Yes Yes Westin et al 13 Yes Weak Yes Yes Castera et al 14 Yes Yes Monto et al 15 Yes Yes Yes Kumar et al 100 Yes Camps et al 101 Yes (BMI) Kaserer et al 102 Yes Bressler et al 60 Yes (BMI) Rubbia-Brandt et al 28 Yes Yes Poynard et al 16 Yes Yes Yes Yes Yes Patton et al 17 Yes Yes Yes Yes Yes Nair et al 70 No* Marrero et al 103 Yes Ohata et al 74 Yes *Steatosis was a risk for HCC in alcoholic and cryptogenic cirrhosis only. Abbreviation: BMI, body mass index.…”

Hepatic Steatosis, Fibrosis, and Cancer in Elderly Cadavers

“…Steatosis can accelerate the progression of liver fibrosis to cirrhosis and ultimately HCC in these liver diseases (Ohata et al, 2003;Powell et al, 2005;Persico and Iolascon, 2010). Fatty liver is also a common complication of obesity and a risk factor in the development of oxidative stress, insulin resistance, and metabolic syndrome in the liver.…”

Long-term Branched Chain Amino Acid Supplementation Ameliorates Diethylnitrosamine-induced Liver Glutathione S-transferase-p Positivity in Zucker Fatty Rats

“…26 Long-term supplementation of Zucker fatty rats with BCAA improved hepatic steatosis and reduced hepatic triglycerides. 27 Diabetes is also associated with increased levels of insulin and insulinlike growth factors, which are potential cancerpromoting factors.…”